Nursing Path

CARING is the essence of NURSING. -Jean Watson

Nursing Path

Knowing is not enough, we must APPLY. Willing is not enough, we must DO. -Bruce Lee

Nursing Path

Treat the patient as a whole, not just the hole in the patient.

Nursing Path

Success is not final. Failure is not fatal. It is the courage to continue that counts. -Winston Churchill

Nursing Path

A problem is a chance for you to do your best. -Duke Ellington

NMC vows to become ‘driving force’ in stamping out discrimination in nursing

The Nursing and Midwifery Council has pledged to take action to help drive out discrimination and enforce “positive, long-lasting change” across the nursing profession, in the wake of new research. The nursing regulator has today published a new report exploring the impact of its processes…

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NHS England pledges extra £15m for staff mental health care in second wave

Nurses in the English NHS struggling with their mental health this winter have been promised access to “rapid assessment and treatment” as part of a new £15m investment. Plans for the funding boost were first revealed yesterday by chief nursing officer for England, Ruth May,…

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Make sure you watch the Student Nursing Times Awards next week

Calling all students, supervisors and educators, make sure you do not miss next week’s ceremony to reveal the winners of the 2020 Student Nursing Times Awards. As ever, this year’s Student Nursing Times Awards will bring together the nursing community to shine a light on…

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‘No stigma’ in nurses seeking mental health support, CNOs urge

The most senior nurses in the UK today spoke out to acknowledge the huge psychological stress placed on the profession by Covid-19 and assured staff they will face “no stigma” for asking for help. Speaking at a nursing conference, Ruth May, Professor Jean White, and…

The post ‘No stigma’ in nurses seeking mental health support, CNOs urge appeared first on Nursing Times.



‘Circuit-breaker’ lockdowns for Wales and NI to curb Covid-19 spread

Climbing hospital admissions and an increase in intensive care patients have led to further lockdown action being taken across Wales and Northern Ireland to help stop the spread of Covid-19. A 17-day “fire-breaker” lockdown will be implemented in Wales from 6pm on Friday amid growing…

The post ‘Circuit-breaker’ lockdowns for Wales and NI to curb Covid-19 spread appeared first on Nursing Times.



North West at ‘critical point’ in Covid-19 fight as beds run short

Intensive care bed capacity in the North West of England is “becoming more of an issue by the day”, according to nursing leaders who have called for urgent action to prevent the Covid-19 crisis escalating any further in the region. The Royal College of Nursing…

The post North West at ‘critical point’ in Covid-19 fight as beds run short appeared first on Nursing Times.



Care home nursing ‘must be made more attractive’, says CQC head

Until the social care sector is made more attractive to nurses the most vulnerable adults including those with dementia will continue to face problems accessing the support they need, a regulation chief warned today. Speaking at the first-ever Nursing Times Patient Flow Forum, Carolyn Jenkinson,…

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CQC findings on state of care ‘wake-up call’ for nurse investment

The coronavirus pandemic is "magnifying inequalities" in mental health, learning disabilities and social care services, which all continue to be burdened with issues around nurse staffing, inspectors have found. The findings from the Care Quality Commission's latest annual State of Care report for 2019-20 "should…

The post CQC findings on state of care ‘wake-up call’ for nurse investment appeared first on Nursing Times.



Health workers in pandemics at ‘increased risk’ of poor mental health

Mental health disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are “particularly common” in nurses, doctors and other hospital staff during and immediately after pandemics, new research suggests. A team of researchers at the University of East Anglia has today published a study…

The post Health workers in pandemics at ‘increased risk’ of poor mental health appeared first on Nursing Times.



Exclusive: Infection control experts issue open letter on care home visiting

A group of experts in nursing and infection prevention and control (IPC) is today warning against the use of IPC measures as a “rationale” for stopping safe and compassionate visits in care homes during the Covid-19 pandemic. In a new open letter published in Nursing…

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ICU nurses ‘will struggle to cope’ in second wave without redeployment support

Critical care nurses are facing an “impossible” task going into the second wave of the coronavirus pandemic during the winter without the support of redeployed staff, a nursing leader has warned. British Association of Critical Care Nurses chair Nicki Credland said the only reason intensive…

The post ICU nurses ‘will struggle to cope’ in second wave without redeployment support appeared first on Nursing Times.



International Nurses’ Day 2021 to shine light on nursing innovation

Nurse innovation in the face of an unprecedented global health crisis will be the focus of International Nurses' Day 2021, it has been announced. The International Council of Nurses is searching for nurses across the world who are taking the lead on service redesign or…

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Nurse-led study will evaluate end-of-life care before and after Covid-19

A new research project has been launched to assess the effectiveness of the “Swan” model of end-of-life and bereavement care and the related “Cygnet” role created in response to Covid-19. The study has received funding of £100,000 from the Burdett Trust for Nursing and will…

The post Nurse-led study will evaluate end-of-life care before and after Covid-19 appeared first on Nursing Times.



Government orders review of DNACPR decisions during pandemic

The goverment has asked the Care Quality Commission to carry out a review of how Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made during the coronavirus pandemic. The scope of the inquiry, ordered by the Department of Health and Social Care, is still being…

The post Government orders review of DNACPR decisions during pandemic appeared first on Nursing Times.



Register now for the first ever Nursing Times Patient Flow Forum

Book your free place now for the inaugural Patient Flow Forum, which will be hosted later this week by Nursing Times. Join link-minded nursing colleagues at the virtual conference that will take place on the afternoon of Thursday 15 October and morning of Friday 16…

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Revival of Nightingale hospitals prompts nurse staffing warnings

Nightingale hospitals in Manchester, Sunderland and Harrogate have been placed on stand-by in response to rising cases of Covid-19 – but questions have been raised about where nurses will be found to staff them. In a briefing at Downing Street today, Professor Jonathan Van-Tam, deputy…

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NHS video showcases ‘amazing contribution’ of mental health nurses

A powerful new video highlighting the life-changing work carried out by mental health nurses and their ability to "offer hope" has been released, featuring testimonials from patients and nurses themselves. Launched to mark World Mental Health Day, the six-minute film aims to thank mental health…

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Microbiology Quiz Series - 19

Anatomy and Physiology Quiz Series - 19

Nursing Management Quiz Series - 21

Nurses celebrated in Covid-19 Queen’s Birthday Honours

More than 50 nurses have been celebrated and recognised with birthday honours from the Queen this year, including two new damehoods for the profession. Nurses working in emergency care, infection prevention and control, public health, research and the military have been named among 1,500 individuals…

The post Nurses celebrated in Covid-19 Queen’s Birthday Honours appeared first on Nursing Times.



Warning against further health visitor and school nurse redeployment

Directors of nursing have been warned against redeploying health visitors and school nurses during a second wave of Covid-19 in the face of increasing child safeguarding concerns. In a joint letter, NHS England’s chief nurse Ruth May; Viv Bennett, chief nurse at Public Health England;…

The post Warning against further health visitor and school nurse redeployment appeared first on Nursing Times.



New social care CNO role advertised as six-month secondment

Eyebrows have been raised over the posting of the government’s new chief nurse for adult social care role for England as an interim, six-month position. The advert for the newly created CNO job went out yesterday and it described the opportunity as a “secondment role…for…

The post New social care CNO role advertised as six-month secondment appeared first on Nursing Times.



Outdated stereotypes ‘putting students off mental health nursing’

Failure to promote the role of mental health nurses correctly, coupled with outdated and negative perceptions of mental health services, is driving potential nurses away from the field at a time when demand is set to soar, a new report has warned. The Nuffield Trust,…

The post Outdated stereotypes ‘putting students off mental health nursing’ appeared first on Nursing Times.



NHS England commits £10m for ‘Long Covid’ clinics

A new network of ‘Long Covid’ clinics is being set up across England to provide specialist support to people experiencing enduring symptoms of Covid-19. NHS England chief executive Sir Simon Stevens announced yesterday that £10m would be invested this year to establish the network. “The…

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Government urged to redress ‘decade of underfunding’ in nursing

The Royal College of Nursing has formally asked the government to use the comprehensive spending review (CSR) to set right what it described as a “decade of lost investment” in the nursing workforce. Launched in July, the CSR is due to conclude this autumn after…

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CQC: Nursing staff wearing masks incorrectly on Kent Covid-19 wards

Inspectors have raised concerns after witnessing nursing staff at a hospital in Kent failing to use personal protective equipment (PPE) correctly while working on Covid-19 wards. Following the inspection, the Care Quality Commission warned East Kent Hospitals University NHS Foundation Trust to make urgent safety…

The post CQC: Nursing staff wearing masks incorrectly on Kent Covid-19 wards appeared first on Nursing Times.



Charity calls for urgent expansion of epilepsy nurse workforce

More epilepsy specialist nurses are desperately needed in Northern Ireland to address gaps in care, a charity has warned. Epilepsy Action Northern Ireland is set to write to health minister Robin Swann to make a case for funding to be allocated for an urgent increase…

The post Charity calls for urgent expansion of epilepsy nurse workforce appeared first on Nursing Times.



Appointments cancelled at practice due to 70% of nursing team self-isolating

A general practice in Lincolnshire has been forced to cancel or delay "a lot" of patient appointments for the next two weeks because much of its nursing team is self-isolating. The Millview Medical Centre has confirmed that three members of its nursing team are in…

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CNO expands her top team to deliver new nursing research strategy

England’s most senior nurse is putting nursing research centre stage of the national agenda with two high-profile appointments to her top team. Chief nursing officer Ruth May (pictured above) has recruited Jo Cooper as her new head of nursing research, research transformation, and Professor Alison…

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RCN will consult members on re-joining global nursing network

The Royal College of Nursing has now confirmed that a consultation will be held with members to seek their views on whether the college should re-join the International Council of Nurses. A survey will run from 30 October until the end of November 2020, before…

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Level of staff burnout ‘real concern’ for NHS trust leaders

Senior leaders in NHS trusts have flagged serious concerns about the wellbeing of staff following the first wave of Covid-19, with 99% worried about the current levels of burnout across the workforce, a new survey has found. The survey was conducted by NHS Providers and…

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Nurse experiences of racism during Covid-19 focus of new film project

Nurses from Black, Asian and minority ethnic (BAME) backgrounds are being invited to share their experiences of discrimination during the coronavirus pandemic for a new research and documentary project. Academics from Sheffield Hallam University have teamed up with film network Migrant Media to launch Nursing…

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New guideline under development for treatment of ‘Long Covid’

A new rapid guideline is being developed to help clinicians identify symptoms and best practice treatment options for persistent effects of Covid-19 – also known as Long Covid. The National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) have…

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RCN confirms extraordinary meeting will be held next month

The Royal College of Nursing will convene an extraordinary general meeting (EGM) at the end of November to discuss problems arising from its presidential election. The plans for the EGM were agreed by members of RCN Council during a meeting held on 1 October. It…

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Covid-19 disrupting mental health services in most countries, finds WHO

Mental health services have been disrupted or halted in 93% of countries across the globe because of the coronavirus pandemic, a new survey from the World Health Organization (WHO) has revealed. The WHO has today released findings of a new survey of 130 countries which…

The post Covid-19 disrupting mental health services in most countries, finds WHO appeared first on Nursing Times.



Retiring nurse leaves legacy ‘akin to Nightingale and Seacole’

A senior nurse who has retired from the NHS after 43 years has been likened to Florence Nightingale and Mary Seacole in terms of her contribution to nursing. Elaine Inglesby-Burke stepped down on 2 October from her role as group chief nursing officer at the…

The post Retiring nurse leaves legacy ‘akin to Nightingale and Seacole’ appeared first on Nursing Times.



NHS seeks to neutralise its carbon footprint by 2040

NHS England has set a new target of 2040 for becoming the first national health system in the world to completely offset its carbon emissions. A new multi-year plan published this week outlined how the organisation, which is responsible for some 4% of the UK’s…

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Additional £50,000 to develop forensic nurse role in Scotland

The Scottish Government has committed a further £50,000 towards plans to develop the role of the nurse sexual offence examiner in the country. The move comes as part of a government-backed Forensic Medical Services (Victims of Sexual Offences) Scotland Bill, which yesterday passed stage one…

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Nurse members of new equality group ‘confident change will happen’

Workplace racism, discrimination and bullying are a regular occurrence for many Black nurses. The psychological impact has left some nurses of colour on sick leave, while others have left the profession completely. But one agency nurse has now launched a grassroots movement to try and…

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Take part in the Nursing Times survey on flu and Covid-19 vaccination

With winter approaching and the coronavirus pandemic showing no signs of letting up, Nursing Times wants to hear from nursing staff on immunisation. The 2020-21 influenza vaccination campaign has been described as being more important than ever and it has also been massively expanded. The…

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Health committee calls for NHS strategy on tackling racism

Calls have been made for a new “strategy” to tackle issues of racism and discrimination faced by nurses from Black, Asian and minority ethnic (BAME) backgrounds in the NHS. A committee of cross-party MPs today warned that more must be done to “eradicate all forms…

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‘Compelling case’ for weekly Covid-19 testing of NHS staff, say MPs

The NHS risks becoming a "Covid-only" service this winter without routine testing for staff, an influential committee of MPs has warned. It said there was a "compelling case" for workers in the NHS to be tested for Covid-19 every week, whether they have symptoms of…

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More than 4,500 speaking up cases raised by nurses last year

Nurses continue to be the most likely profession to raise whisteblowing concerns through their Freedom to Speak Up Guardians, latest data shows. In 2019/20, nurses spoke up more than 4,500 times and were responsbile for 28% of cases lodged, higher than any other occupation, according to…

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RCN leads call for prison healthcare reforms to curb rising deaths

Healthcare in the justice system must be improved to prevent more prisoners dying prematurely, warns a new report by the Royal College of Nursing and a government advisory committee. It comes amid a rise in the number of natural deaths in custody in England and…

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Brexit: Nursing assistants recommended for job shortage list

Nursing assistants are in such short supply in the UK that employers should be given more flexibility to recruit into these roles from overseas after Brexit, the government has been told by a group of expert advisors. The “critical role” people in these jobs were…

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Psychology Quiz Series - 20

‘Blame culture’ in midwifery affecting staff retention, committee told

Issues around the workplace culture in maternity services are driving midwives away from the profession and impacting the safety of care delivered to pregnant women, a committee of MPs has heard. A panel of experts today presented oral evidence to the Health and Social Care…

The post ‘Blame culture’ in midwifery affecting staff retention, committee told appeared first on Nursing Times.



Coronavirus: 90% of NHS leaders worried about staff wellbeing

Nine out of 10 leaders in the English NHS are concerned about the long-term impact of the coronavirus pandemic on the wellbeing of their staff. The finding is revealed in a new report published today by the NHS Confederation titled NHS Reset: A New Direction…

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Analysis: The case for an early pay rise for nurses

Nurses are still recovering from the initial peak of the coronavirus pandemic and now face the challenge of a second wave. Despite the plaudits that have come their way, many still do not feel properly valued. With the clapping now fading but Covid-19 cases again…

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Government promises four-month PPE stockpiles for winter

The government has today published a new national personal protective equipment (PPE) strategy that it claims will secure an “uninterrupted” supply of items for nurses and colleagues treating Covid-19 patients this winter. As part of the strategy, health and social care secretary Matt Hancock announced that…

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Give nurses ‘easy access’ to flu jab during shifts, says RCN

Employers must make getting vaccinated against influenza as easy as possible for their health and care workers by offering jabs on site and during shifts, the Royal College of Nursing has urged. The college made the appeal today as it launched its annual #BeatTheFlu campaign,…

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Microbiology Quiz Series - 18

Chemo nurse learns sign language to improve care for deaf patients

A chemotherapy nurse who taught herself sign language has been praised for the way she has transformed care for deaf patients on her hospital unit in Staffordshire. Dawn Bebbington, staff nurse on the chemotherapy unit at County Hospital in Stafford, was inspired to learn British…

The post Chemo nurse learns sign language to improve care for deaf patients appeared first on Nursing Times.



NMC launches new code of practice campaign

The nursing regulator has today launched a new campaign to “bring to life” its code of practice and highlight how it can be used to guide difficult decision making during the coronavirus pandemic and beyond. Caring with Confidence will involve a series of short animations…

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Anatomy and Physiology Quiz Series - 18

News round-up: Catch-up on September’s major nursing stories

Miss any of the news affecting the profession during September 2020? Catch up with our monthly summary of the main nursing headlines, as reported by Nursing Times.   Nurses to access clear face masks to improve communication Nurses across the UK are set to have…

The post News round-up: Catch-up on September’s major nursing stories appeared first on Nursing Times.



Nursing Management Quiz Series - 20

RCN election row: Petitioners and council find common ground

Talks between council members at the Royal College of Nursing and petitioners seeking to force change at the college through an extraordinary general meeting (EGM) appear to have taken a positive turn. The two sides met last night and agreed to work together to organise…

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Care home nurses ‘highest priority’ for Covid-19 vaccine in draft list

Nurses have been labelled as a top priority for a Covid-19 vaccine – especially those in care homes – by a committee advising the government on immunisation. The Joint Committee on Vaccination and Immunisation (JCVI) has today published 11 draft groups it believes should be…

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Warning over fate of flu campaign if GPNs go without Covid-19 tests

Problems in access to Covid-19 testing for general practice nurses will threaten the ability of primary care to deliver this year's expanded influenza vaccination programme, the government has been warned. The Royal College of General Practitioners (RCGP) has this week written to Baroness Dido Harding…

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RCN welcomes ‘important’ review of gender services for young people

Nursing leaders have welcomed an announcement by NHS England of an independent review into gender identity services for children and young people. The review will be wide-ranging in scope and will look to make recommendations on the current and future workforce needs for these services.…

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Nursing Research Quiz Series - 23

‘Record’ rise in student nurses including 30% more men

A record number of students have been placed on nursing courses across the UK this year, new figures from the Universities and Colleges Admissions Service (UCAS) reveal. The data, published 28 days after the clearing process, showed 34,190 student nurses had been accepted onto a…

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Staff discrimination named ‘biggest workforce issue of pandemic’

Discrimination faced by health and care staff from a Black and minority ethnic (BME) background has been described as the “biggest workforce issue of the pandemic”, according to a new report. The NHS Confederation report, published today, set out a list of key actions that…

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RCN Wales urges next government to ‘value the profession’

The Royal College of Nursing in Wales has launched a new manifesto that calls on the next Welsh Government to provide a “substantive” pay rise and extend safe staffing legislation. RCN Wales has this week published its Vote for Nursing Campaign to lobby the next…

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Influential director of RCN Scotland announces retirement

Theresa Fyffe, director of the Royal College of Nursing in Scotland, has announced that she will retire from the college after 14 years in the top role. A former critical care nurse, Ms Fyffe (pictured above) has been commended for raising the RCN’s profile in…

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Government places nurses in new Covid-19 testing priority list

Care home staff have been placed second and NHS staff third on a new priority list for Covid-19 testing, the government has announced. Nursing leaders and unions have been calling on the government in recent weeks to ensure nursing staff and colleagues were front of…

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Nurses working under ‘damaging conditions’, warns report

Urgent action is needed to address “alarmingly high levels” of nurse stress, turnover and intentions to quit, which have been exacerbated by the coronavirus pandemic, a new report has warned. A blueprint published today by the King’s Fund health think tank called on organisations to…

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Government’s 50,000 nurse pledge ‘not based on modelling’

The government appears to be unaware of how many nurses the NHS in England actually needs and in what specialisms to meet demand, an influential committee of MPs has warned. It said the Department of Health and Social Care (DHSC) "could not show" that its…

The post Government’s 50,000 nurse pledge ‘not based on modelling’ appeared first on Nursing Times.



Government agrees to sign charter to ‘protect health workers’

The health and social care secretary, Matt Hancock, has agreed to sign up to a new health worker safety charter, which vows to protect staff from violence, biological hazards, and improve their mental health. On World Patient Safety Day last week, the World Health Organization…

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CNO announces £28m to restart international nurse recruitment

Funding worth £28m is being made available in England to quickly “accelerate” the recruitment of nurses from overseas, following a period of inactivity due to the coronavirus pandemic. Half of the money is dedicated to supporting the arrival to the country of nurses who have…

The post CNO announces £28m to restart international nurse recruitment appeared first on Nursing Times.



Long-standing leader of health visiting body to ‘step back’ from role

The Institute of Health Visiting (iHV) has announced that Dr Cheryll Adams, who founded the organisation, will be stepping back from her role as executive director early next year. Current director of policy and quality at the institute, Alison Morton, will become acting executive director…

The post Long-standing leader of health visiting body to ‘step back’ from role appeared first on Nursing Times.



Action needed ‘now’ to protect nurses as Covid-19 infections soar

Nursing leaders have called for action to ensure resources are in place for nurses to tackle a second wave of Covid-19 amid a rapid rise in cases nationally. The resurgence in cases has led to the UK’s four chief medical officers recommending this afternoon that…

The post Action needed ‘now’ to protect nurses as Covid-19 infections soar appeared first on Nursing Times.



CNO calls on nurses to tackle 10k challenge for colleagues in crisis

The chief nursing officer for England has issued a plea to nurses and midwives to support colleagues facing personal and financial crises by taking on a 10k challenge of their choosing. Ruth May has urged staff to sign up to this year’s '10k for Nurses…

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Nurse says new dementia village is benefiting staff and patients

A new dementia 'village’ at a hospital site in the East Midlands is supporting patients to "live the best life they can", according to a senior nurse who works there. Featuring a communal green, a post office, a village hall, a launderette and bus stop,…

The post Nurse says new dementia village is benefiting staff and patients appeared first on Nursing Times.



England launches trial of A&E appointment system

A new appointment booking system for urgent care is being trialled in England as part of efforts to curb the spread of Covid-19. Under the pilot, people with a non-life-threatening problem will be asked to phone the NHS 111 service to be triaged before attending…

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DHSC announces new adult social care chief nurse role

A new chief nurse role for adult social care role is being created to help steer the workforce through the challenges of the upcoming winter and beyond. Recruitment for the position will begin in October and the successful candidate will charged with providing clinical and…

The post DHSC announces new adult social care chief nurse role appeared first on Nursing Times.



Northern Irish nurse says ‘weary’ staff fear second Covid-19 wave

A senior nurse in Northern Ireland with more than 20 years' experience in emergency care has said she has never before seen colleagues "so worried about the incoming winter". At a time when the number of Covid-19 cases in the country are rising, Roisin Devlin,…

The post Northern Irish nurse says ‘weary’ staff fear second Covid-19 wave appeared first on Nursing Times.



RCN schedules 2021 vote on re-joining global nursing federation

Members of the Royal College of Nursing will be asked to vote next year on whether the college should re-join the International Council of Nurses. Ahead of the planned vote at its 2021 annual general meeting, the college is set to hold an engagement exercise…

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RCN row continues as petitioners complain of being shut out

The Royal College of Nursing presidential election row is continuing to rumble on despite promises of an extraordinary general meeting (EGM). The college’s governing council announced yesterday that it would be calling an EGM in the near future to give members an opportunity to air…

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Europe will extend year of the nurse and midwife into 2021

The International Year of the Nurse and Midwife will be extended in Europe in the wake of the coronavirus pandemic, it has been announced. The a World Health Organization (WHO) had dedicated 2020 to nurses and midwives to showcase and celebrate the work of the…

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No patient safety without nurse safety, governments warned

Patient safety and the safety of nurses are “two sides of the same coin”, nursing leaders across the UK and globally have warned today. They are using this year's World Patient Safety Day to call for action and investment in order to protect nurse health…

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Consultation launched on extension of Welsh nurse staffing law

Plans to extend safe nurse staffing legislation in Wales to include children’s inpatient wards have taken a step forward, as a 12-week consultation is launched. The Welsh Government is now gathering views on changes to the law to include paediatric inpatient wards. “While we welcome…

The post Consultation launched on extension of Welsh nurse staffing law appeared first on Nursing Times.



Further funds announced to control Covid-19 infections in care homes

An emergency support fund to help limit the spread of Covid-19 in care homes in England is being topped up with an additional £546m ahead of the winter. A key purpose of the Infection Control Fund is to help the care sector restrict the movement…

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Emergency meeting of RCN will ‘give members space to air concerns’

An extraordinary general meeting (EGM) of the Royal College of Nursing will be convened “soon”, the chair of the college’s ruling council has announced. Dave Dawes (pictured above) said the EGM would provide members with a space to air their concerns following a stormy few…

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‘Vital’ for nurses to take up flu jab this year, warns CNO

The annual call for health and care staff to take up the offer of a free influenza vaccination is more imperative than ever this year in light of Covid-19, England’s chief nursing officer has warned. With the first flu vaccine deliveries due to reach employers…

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Emergency care forms tweaked to make them more ‘patient-centred’

The process used to discuss and document an individual's emergency care wishes has been altered in order to make it more "patient-centred" and reduce the likelihood of "misunderstandings". The changes follow concerns raised during the coronavirus pandemic about the way decisions were being made about…

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Punishments to get ‘even tougher’ for people who attack nurses

Maximum prison sentences for people who assault nurses are set to be increased again, this time from one year to two, the government has announced. It follows the introduction in 2018 of the Assaults on Emergency Workers (Offences) Act that made it a specific crime…

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Psychology Quiz Series - 19

World’s governments have ‘failed to prioritise’ nurses during Covid-19

Calls have been made for governments to address their “collective failure” to prioritise nurses during the coronavirus pandemic, as a new report reveals a “disturbing snapshot” of how health workers are being exposed to the virus and its associated risks. In a new report published…

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Covid-19 test results for care home nurses ‘consistently delayed and lost’

Care home nurses continue to struggle with access to coronavirus tests, with some reporting that results are “consistently delayed, inconclusive or even get lost”, according to a nursing union. The Royal College of Nursing has warned that, without proper testing and processes in place, the…

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Finalists of the 2020 Nursing Times Workforce Awards revealed

The people and organisations that have made the shortlist for the 2020 Nursing Times Workforce Awards has been announced today. We received over 100 entries, giving our judges a tough job to whittle these down into our shortlist across the award’s 15 categories. The event,…

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Giant sea turtle named in honour of nurses returned to ocean

A giant seagoing turtle that was rescued from a beach in the US in May, and named after Florence Nightingale, has been released back into the ocean after a full recovery from injury. As previously reported by Nursing Times, the turtle was found stranded and…

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Covid-19 risk in hospitals ‘lowest among intensive care staff’

The risk of Covid-19 infection among staff at the height of the coronavirus pandemic was lowest among intensive care clinicians, contrary to expectations, according to findings in one UK hospital. In contrast, coronavirus risk was found to be highest among acute and general medicine clinicians,…

The post Covid-19 risk in hospitals ‘lowest among intensive care staff’ appeared first on Nursing Times.



Nurses to raise funds for mental health unit with 100 mile walk

A pair of nurses have put on their walking boots and set off on what they have coined a ‘walk to recovery’, in a bid to raise money to improve patient activities at a psychiatric intensive care unit (PICU) in Sunderland. Tom Gardner and Ryan…

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‘More specialist midwives needed’ to support BAME women

Urgent changes must be made to ensure maternity care is safer for Black, Asian and minority ethnic (BAME) women,  according to the Royal College of Midwives. In a motion at the Trades Union Congress (TUC) annual conference today, the RCM insisted that more specialist midwives…

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Nurses ‘continue fight’ for pay increase amid protest cancellations

Up to 3,000 nurses and health workers took part in a series of online and in-person pay protests across the country this weekend, despite several being cancelled because of the rise in coronavirus cases. Nurses both lined the streets and joined together virtually to continue…

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Microbiology Quiz Series - 17

Anatomy and Physiology Quiz Series - 17

Nursing Management Quiz Series - 19

Coronavirus case rise postpones half of nurse weekend pay protests

Nurses fighting for a pay rise have confirmed that nearly half the physical demonstrations organised for this weekend have been forced to be postponed following the rise in coronavirus cases across the country. On Saturday 12 September, 19 demonstrations were set to take place throughout…

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HEE to fund ‘top-up’ apprenticeships for nursing associates

A new funding offer will support more than 400 nursing associates and assistant practitioners to undertake a two-year ‘top-up’ apprenticeship to become registered nurses. Health Education England has this week announced it will fund 420 new apprentices, starting from September. “This much needed funding will…

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First for mental health and learning disability education on Guernsey

For the first time ever, learning disability and mental health nurse education is to begin on Guernsey, allowing the Channel Island to “grow its own” nurses in those two specialties. Learning disability and mental health nurse education, endorsed by the Nursing and Midwifery Council, will…

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Nursing Research Quiz Series - 22

New scoring tool ‘accurately predicts Covid-19 death risk’

A team of UK researchers has developed an “easy-to-use” scoring system to help predict mortality risk in patients admitted to hospital with Covid-19. Those behind the new system said it could be used by clinicians to inform treatment decisions and to stratify coronavirus patients into…

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Half of returnees on NMC temporary register ‘might stay’

Almost half of the nursing professionals who returned to practice to support the UK coronavirus response would consider staying on permanently, a survey reveals. The Nursing and Midwifery Council has today published the findings of a snapshot analysis of its Covid-19 temporary register as of…

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Analysis: Nursing and the quest for equality in NHS leadership

Nursing is the "most common route" for women to become chief executives in the NHS, according to a new report, which also highlighted ongoing challenges around race inequality in the profession. The NHS Confederation's Health and Care Women Leaders Network found that the health service…

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Trust looks to ‘accelerate’ nursing innovation with new fellowship

A new fellowship is being made available at Chelsea and Westminster Hospital NHS Foundation Trust in a bid to bolster nursing innovation across the organisation. The "first of its kind" Nursing Innovation Fellow position has come to life thanks to a grant from the Burdett…

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Free webinar on vital signs monitoring for deterioration and sepsis

The earlier detection of deterioration in patients is an incredibly important topic for nurses because it leads to better outcomes and more lives saved. In recognition of this importance, Nursing Times is exploring the use of vital signs monitoring to better detect deterioration and sepsis…

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CQC tells London hospital to urgently improve infection control

Inspectors have ordered a hospital trust in west London to improve its infection prevention and control practices following a Covid-19 outbreak among staff. The Care Quality Commission has used its regulatory powers to force Hillingdon Hospital NHS Foundation Trust to make urgent changes for the…

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Nurses to access clear face masks to improve communication

Nurses across the UK are set to have access to clear face masks in a bid to improve communication with individuals who rely on lip reading and facial expressions, during the coronavirus pandemic. The government has announced that 250,000 clear face masks will be delivered…

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Child Health Nursing Quiz Series - 18

Long-serving mental health nurse dies after contracting Covid-19

A mental health nurse who had dedicated almost 30 years to working for the NHS after moving to England from Tanzania has died after contracting Covid-19. Wilbald Tesha, known to his colleagues and friends as Tesha, was a mental health nurse for the Department of…

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Good nursing hospitals deliver better outcomes at ‘no extra cost’

Investment in hospital nurses leads to better patient outcomes and pays for itself financially through improved care, according to a study by US nursing academics. It found patients admitted to hospitals with good nurse staffing and work environments were less likely to die or be…

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Equality 4 Black Nurses group seeks to tackle workplace racism

An agency nurse fighting to stamp out racial discrimination in the health and care sector has launched a grassroots movement to support Black nurses and lobby for change. Drawing on her own experiences of discrimination at work, Neomi Bennett has created the Equality 4 Black…

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Survey uncovers ‘almost accepted’ bullying culture in perioperative teams

Most perioperative nursing staff in the UK have witnessed or experienced bullying at work, a new survey has revealed. The poll of almost 700 UK theatre practitioners found that bullying was a significant and widespread problem in operating departments and had become “almost accepted” in…

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Symptoms and causes of anxiety and its diagnosis and management

All nurses will meet people who experience anxiety, and an awareness of the underlying causes, simple interventions and when to refer to specialist services can help patients to manage their symptoms. This article comes with a self-assessment enabling you to test your knowledge after reading…

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New RCN Council chair commits to review of president election

An independent review will be commissioned into the Royal College of Nursing’s 2020 presidential election and the events that led to its break down, the new chair of RCN Council has pledged. The council would also adhere to calls for an extraordinary general meeting (EGM),…

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Nurse manager back on frontline after four-month Covid-19 journey

A critical care nurse who spent almost two weeks in the intensive care unit she runs and four months off work because of her Covid-19 diagnosis has now recovered enough to return to the frontline. Sue Snelson, a critical care outreach nurse specialist, was in…

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ICU nurse captures the impact of Covid-19 on the workforce

An intensive care nurse has photographed the emotions and experiences of colleagues working on the front line of the coronavirus pandemic to reflect the “mounting pressures” staff were under. Emily Gilhespy told Nursing Times that she decided to spend her breaks from an acute intensive…

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Dexamethasone

 

Generic Name : dexamethasone,dexamethasone acetate , dexamethasone sodium phosphate

Brand Name:

  • Oral, topical dermatologic aerosol and gel, ophthalmic suspension: Aeroseb-Dex, Decadron, Hexadrol, Maxidex Ophthalmic, ratio-Dexanamethasone (CAN)
  • IM, intra-articular, or soft-tissue injection: Cortastat LA, Dalalone L.A., Decaject LA, Dexasone-L.A., Dexone LA, Solurex LA
  • IV, IM, intra-articular, intralesional injection; respiratory inhalant; intranasal steroid; ophthalmic solution and ointment; topical dermatologic cream: Cortastat, Dalalone, Decadron Phosphate, Decaject, Dexasone, Hexadrol Phosphate, Solurex

Classification: Corticosteroid, Glucocorticoid, Hormone

Pregnancy Category C

Dosage & Route

ADULTS

Systemic administration

  • Individualize dosage based on severity of condition and response. Give daily dose before 9 AM to minimize adrenal suppression. If long-term therapy is needed, alternate-day therapy with a short-acting steroid should be considered. After long-term therapy, withdraw drug slowly to avoid adrenal insufficiency. For maintenance therapy, reduce initial dose in small increments at intervals until the lowest clinically satisfactory dose is reached.

Oral (dexamethasone)

  • 0.75–9 mg/day.
  • Suppression test for Cushing’s syndrome: 1 mg at 11 AM; assay plasma cortisol at 8 AM the next day. For greater accuracy, give 0.5 mg q 6 hr for 48 hr, and collect 24-hr urine to determine 17-hydroxycorticosteroid (17-OHCS) excretion.
  • Suppression test to distinguish Cushing’s syndrome due to ACTH excess from that resulting from other causes: 2 mg q 6 hr for 48 hr. Collect 24-hr urine to determine 17-OHCS excretion.

IM (dexamethasone acetate)

  • 8–16 mg; may repeat in 1–3 wk.

IV or IM (dexamethasone sodium phosphate)

  • 0.5–9 mg/day.
  • Cerebral edema: 10 mg IV and then 4 mg IM q 6 hr until cerebral edema symptoms subside; change to oral therapy, 1–3 mg tid, as soon as possible and taper over 5–7 days.

PEDIATRIC PATIENTS

  • Individualize dosage based on severity of condition and response, rather than by strict adherence to formulas that correct adult doses for age or body weight. Carefully observe growth and development in infants and children on long-term therapy.

IV

  • Unresponsive shock: 1–6 mg/kg as a single IV injection (as much as 40 mg initially followed by repeated injections q 2–6 hr has been reported).

Intralesional (dexamethasone acetate)

ADULTS AND PEDIATRIC PATIENTS

  • 4–16 mg intra-articular, soft tissue; 0.8–1.6 mg intralesional.

(dexamethasone sodium phosphate)

  • 0.4–6 mg (depending on joint or soft-tissue injection site).
  • Respiratory inhalant (dexamethasone sodium phosphate)
  • 84 mcg released with each actuation.

ADULTS

  • 3 inhalations tid–qid, not to exceed 12 inhalations/day.

PEDIATRIC PATIENTS

  • 2 inhalations tid–qid, not to exceed 8 inhalations/day.
  • Intranasal (dexamethasone sodium phosphate)
  • Each spray delivers 84 mcg dexamethasone.

ADULTS

  • 2 sprays (168 mcg) into each nostril bid–tid, not to exceed 12 sprays (1,008 mcg)/day.

PEDIATRIC PATIENTS

  • 1 or 2 sprays (84–168 mcg) into each nostril bid, depending on age, not to exceed 8 sprays (672 mcg). Arrange to reduce dose and discontinue therapy as soon as possible.

Topical dermatologic preparations

ADULTS AND PEDIATRIC PATIENTS

  • Apply sparingly to affected area bid–qid.
  • Ophthalmic solutions, suspensions

ADULTS AND PEDIATRIC PATIENTS

  • Instill 1 or 2 drops into the conjunctival sac q 1 hr during the day and q 2 hr during the night; after a favorable response, reduce dose to 1 drop q 4 hr and then 1 drop tid–qid.
  • Ophthalmic ointment

ADULTS AND PEDIATRIC PATIENTS

  • Apply a thin coating in the lower conjunctival sac tid–qid; reduce dosage to bid and then qid after improvement.
Therapeutic actions
  • Dexamethasone is a synthetic glucocorticoid which decreases inflammation by inhibiting the migration of leukocytes and reversal of increased capillary permeability. It suppresses normal immune response
Indications
  • Hypercalcemia associated with cancer
  • Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (SLE), dermatologic diseases (pemphigus), status asthmaticus, and autoimmune disorders
  • Hematologic disorders: Thrombocytopenic purpura, erythroblastopenia
  • Trichinosis with neurologic or myocardial involvement
  • Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas
  • Cerebral edema associated with brain tumor, craniotomy, or head injury
  • Testing adrenocortical hyperfunction
  • Unlabeled uses: Antiemetic for cisplatin-induced vomiting, diagnosis of depression
  • Intra-articular or soft-tissue administration: Arthritis, psoriatic plaques
  • Respiratory inhalant: Control of bronchial asthma requiring corticosteroids in conjunction with other therapy
  • Intranasal: Relief of symptoms of seasonal or perennial rhinitis that responds poorly to other treatments
  • Dermatologic preparations: Relief of inflammatory and pruritic manifestations of dermatoses that are steroid-responsive
  • Ophthalmic preparations: Inflammation of the lid, conjunctiva, cornea, and globe
Adverse effects
  • Growth retardation, osteoporosis, peptic ulcer, glaucoma and subcapsular cataracts, vertebral compression fractures. Cushing-like features, pancreatic dysfunction and pancreatitis, GI upsets, increased appetite, increased fragility of the skin. Increased susceptibility to infection. Topical application: Dermal atrophy, local irritation, folliculitis, delayed wound healing, systemic absorption and toxicity with occlusive dressing on application to large areas of the body and broken skin. Topical application to eye: Corneal ulcers, glaucoma and reduced visual ability. Inhalation: Hoarseness, candidiasis of mouth and throat. Intra-articular inj: Aseptic necrosis of bone and joint damage.
  • Potentially Fatal: HPA supression; CV collapse on rapid IV admin.
Contraindications
  • Hypersensitivity; active untreated infections; ophthalmic use in viral, fungal disease of the eye.
Nursing considerations
Assessment
  • History for systemic administration: Active infections; renal or hepatic disease; hypothyroidism, ulcerative colitis; diverticulitis; active or latent peptic ulcer; inflammatory bowel disease; CHF, hypertension, thromboembolic disorders; osteoporosis; seizure disorders; diabetes mellitus; lactation
  • History for ophthalmic preparations: Acute superficial herpes simplex keratitis, fungal infections of ocular structures; vaccinia, varicella, and other viral diseases of the cornea and conjunctiva; ocular TB
  • Physical for systemic administration: Baseline body weight, T; reflexes, and grip strength, affect, and orientation; P, BP, peripheral perfusion, prominence of superficial veins; R and adventitious sounds; serum electrolytes, blood glucose
  • Physical for topical dermatologic preparations: Affected area for infections, skin injury
Interventions
  • For systemic administration, do not give drug to nursing mothers; drug is secreted in breast milk.
  • WARNING: Give daily doses before 9 AM to mimic normal peak corticosteroid blood levels.
  • Increase dosage when patient is subject to stress.
  • Taper doses when discontinuing high-dose or long-term therapy.
  • Do not give live virus vaccines with immunosuppressive doses of corticosteroids.
  • For respiratory inhalant, intranasal preparation, do not use respiratory inhalant during an acute asthmatic attack or to manage status asthmaticus.
  • Do not use intranasal product with untreated local nasal infections, epistaxis, nasal trauma, septal ulcers, or recent nasal surgery.
  • WARNING: Taper systemic steroids carefully during transfer to inhalational steroids; adrenal insufficiency deaths have occurred.
  • For topical dermatologic preparations, use caution when occlusive dressings, tight diapers cover affected area; these can increase systemic absorption.
  • Avoid prolonged use near the eyes, in genital and rectal areas, and in skin creases.
Teaching points

Systemic administration

  • Do not stop taking the oral drug without consulting your health care provider.
  • Avoid exposure to infection.
  • Report unusual weight gain, swelling of the extremities, muscle weakness, black or tarry stools, fever, prolonged sore throat, colds or other infections, worsening of this disorder.

Intra-articular administration

  • Do not overuse joint after therapy, even if pain is gone.

Respiratory inhalant, intranasal preparation

  • Do not use more often than prescribed.
  • Do not stop using this drug without consulting health care provider.
  • Use the inhalational bronchodilator drug before using the oral inhalant product when using both.
  • Administer decongestant nose drops first if nasal passages are blocked.

Topical

  • Apply the drug sparingly.
  • Avoid contact with eyes.
  • Report any irritation or infection at the site of application.

Ophthalmic

  • Administer as follows: Lie down or tilt head backward and look at ceiling. Warm tube of ointment in hand for several minutes. Apply one-fourth to one-half inch of ointment, or drop suspension inside lower eyelid while looking up. After applying ointment, close eyelids and roll eyeball in all directions. After instilling eye drops, release lower lid, but do not blink for at least 30 seconds; apply gentle pressure to the inside corner of the eye for 1 minute. Do not close eyes tightly, and try not to blink more often than usual; do not touch ointment tube or dropper to eye, fingers, or any surface.
  • Wait at least 10 minutes before using any other eye preparations.
  • Eyes will become more sensitive to light (use sunglasses).
  • Report worsening of the condition, pain, itching, swelling of the eye, failure of the condition to improve after 1 week.